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PRACTICE STAFF’S VIEWS ON A COMMUNITY PHARMACY-LED MEDICINES MANAGEMENT SERVICE 
Tinelli M, Jaffray M, Bond C, Watson M 
on the behalf of Community Pharmacy Medicines Management Evaluation Team
Department of General Practice and Primary Care, University of Aberdeen, Westburn Road, Aberdeen, AB25 2AY
c.m.bond@abdn.ac.uk

Introduction 
Recent organisational changes within United Kingdom health care systems have had major impact on primary care delivery1 including an increased role for community pharmacists (CPs) in the delivery of a medicines management service2. It is crucial that this role is supported by other members of the primary health care team. The Community Pharmacy Medicines Management Project3 was a large randomised controlled trial (RCT) to evaluate the introduction of medicines management service by CPs for patients with coronary heart disease (CHD). It was conducted in nine Health Authorities in England. The aim of the survey presented here was to investigate participating practice staff (general practitioners (GPs), nurses (PNs), pharmacists (PPs), and managers (PMs)) views on this service. 

Methods 
A questionnaire survey was conducted. Four profession-specific questionnaires (GP, PN, PP, PM) were developed, using the same questions wherever possible to permit direct comparisons. The items included respondents’ demography, professional opinion of medicines management services, communication with CPs and opinions of the innovative role of CPs. A small pilot study was conducted in one health centre in Grampian, Scotland. Minor changes to the wording and format were made to the final version. All GPs, PNs, PPs and PMs involved in the Medicines Management Project were sent a questionnaire at baseline and after a 12-month follow-up. A single, personal reminder was sent after two weeks. Returned questionnaires were entered manually into SPSS v11.5.

Results 
The response rates at baseline and at follow-up respectively were as follows: GPs 70% (119/170) and 52% (76/147); PPs 77% (30/39) and 56% (22/39); PPs 51% (20/39) and 36% (14/39); PMs 80% (31/39) and 46% (18/39). Support was strongest across all professional groups for CPs to advise on complications with medicines and was lowest for screening for early indications of disease. PNs were least likely to agree that CPs should provide screening services, with just over one third indicating support. Across all the four professional groupings, agreement was highest that such services would lead to fuller utilization of CPs’ knowledge and fewer problems with multi-treatment therapy. Agreement was lowest for more joint working between GPs and CPs. While the majority of respondents in all groups believed that they currently had good relationships with CPs, there was strong agreement that there was room for improvement. The majority of GPs, PNs and PPs agreed that CPs have sufficient knowledge to assist GPs to prescribe more effectively. Most GPs, PPs and PMs agreed that such advice from CPs would lead to fewer prescribing errors. However, all professional groups believed that there was insufficient opportunity for CPs to discuss prescribing issues with other professionals. The results did not change at follow-up. 

Discussion 
All practice staff expressed strong support for a wider role for CPs in medicines management, at both baseline and follow-up. The highly positive results at baseline left little room for improvement, which could have occurred as a result of experiencing the service. These positive attitudes indicate willingness of practice staff to engage with CPs in a single, integrated primary health care team. 

References

  1. Wall A. Look back in wonder. Health Service Journal 1998; 15-16

  2. http://www.managingmedicines.com. (Last visited 01/12/04);

  3. http://www.medicinesmanagement.org.uk (Last visited: 01/12/04).


Presented at the HSRPP Conference 2005, Reading